Traumi cervicali in urgenza

The superior (C0-C2) cervical spine must not be fused unless it is absolutely necessary. The fusion must then be done in the most limited possible manner. In case of listhesis the first goal is to realign the vertebral bodies by transkeletal traction. Later the surgeon will choose between conservative (immobilization in Halo) and surgical treatment. The A uthors review the principles and the objectives of the surgical therapy as well as the technical meaning of the surgical procedures along with the different approaches to the superior cervical spine particularly with reference to odontoid fractures and to the indications to the different techniques. The Authors stress the importance of a correct and careful surgical indication in order to achieve a result as better as possible. As regards the inferior cervical spine the Authors review the biomechanical pathogenesis of the cervical traumas, the technical characteristics and the indications to the anterior, posterior and combined approach whereas they outline the features of the most commonly used materials (plates and screws), the best insertion points for the screws (posterior approach), the advantages and disadvantages of the various techniques and the most frequent complications of the different approaches.